Trever Dahms, Medicare Insurance Broker

Answer: Honestly, I don't recommend one over the other, and if an agent tells you flatly that one is better, that's actually a red flag worth paying attention to. The truth is, neither one is universally better. They're just built differently, and the right fit depends entirely on your situation. That said, if premium isn't a concern for you, I'll usually point people toward Medigap simply because of the freedom it offers.

What actually determines the right answer for you comes down to a few things:

- How often you travel

- Whether you have specialists or a hospital system you're attached to

- What medications you're on,

- Your budget

- Your risk tolerance.

Someone who's healthy, stays local, and wants to save money month to month might do great on Advantage. Someone who travels constantly or has a complex health situation might be much better served by a Medigap plan, even at a higher premium

Answer: Picking a Medicare Advantage plan based on the $0 premium and not understanding what they're trading away to get it. If you want to move to a Medigap plan later and you're outside your initial enrollment period, you may have to go through medical underwriting and depending on your health at that point, you could be denied or charged more.

Answer: Medigap exists for exactly the reason you chose it. With a Medigap plan, you have the freedom to see any doctor or specialist in the country who accepts Medicare, no networks, no referrals needed.

That said, paying a premium that feels like "a fortune" doesn't necessarily mean Medigap was the wrong choice. It might mean you're paying too much for it. It's worth having someone shop the market to see if another carrier offers the same plan letter at a lower price, since Medigap plans are standardized and the only real difference between carriers is cost.

If the premium is genuinely too much of a financial strain, it may also be worth looking at a Medicare Advantage PPO. A PPO still gives you a national network, while typically coming with a much lower premium than Medigap. It's not the same as having no network at all, but for someone who needs to ease the financial pressure, it can be a reasonable middle ground.

Answer: Heres where I would look if you are trying to figure out on your own.

1) Check the specific plan's formulary, not Medicare in general. Drug coverage isn't decided by "Medicare" as a whole and varies plan by plan. Whether your medication is covered depends entirely on which Part D or Medicare Advantage plan you're enrolled in.

2) Use Medicare's official plan finder tool. At medicare.gov, you can enter your specific medications and dosages and see exactly how each plan in your area covers them, including the tier and any restrictions.

3) Call the plan directly. Your specific plan's member services line can confirm coverage, copay amount, and whether there are restrictions like prior authorization or step therapy on that exact medication.

Answer: Medicare can feel overwhelming. I always joke that I'm thankful they made it so confusing, because it's given me a job. But in all seriousness, I sit down with people who are stressed and confused, and by the end of our conversation, I watch that stress turn into clarity. That shift is what I love most about this job.

Answer: Yes, here is how its changing and how it could help you out:

1) There's now a hard cap on out-of-pocket drug costs. Once you hit $2,000 in out-of-pocket spending for the year, your covered Part D drugs are free for the rest of the year

2) The old "donut hole" is gone. Previously, even after reaching catastrophic coverage, you still owed a percentage of your drug costs. That's eliminated now. Once you hit the $2,000 cap, you're done paying for the year.

3) You can spread costs out monthly if you want. There's a new option called the Medicare Prescription Payment Plan that lets you pay your out-of-pocket drug costs in monthly installments throughout the year instead of getting hit with a huge cost early on.

Answer: Here are the 3 biggest mistakes I see with seniors when choosing a Medicare Part D plan:

1) Not reviewing their medication list against the plan's formulary. A plan can look great on paper, but if one of your prescriptions isn't covered, or is in a higher tier than expected, you could end up paying far more than you planned.

2) Not understanding when the deductible applies. Some plans have no deductible, others have one that applies to certain drug tiers but not others and if you don't know how that works, your first few prescription fills of the year can come as a real surprise.

3) Going with a "name brand" without comparing options. A lot of people just re-enroll in the same well-known plan year after year, or pick whatever carrier they recognize, without ever running their actual medications through a comparison. The most recognizable name isn't always the cheapest or best fit for your specific drugs.

Answer: Yes, since your husband's employer plan covers 20+ employees, it counts as creditable coverage for both Medicare and Part D. So you can delay enrolling in Part A, Part B, and Part D without a late enrollment penalty as long as that coverage stays in place. Once the employer coverage ends, you'll get an 8-month Special Enrollment Period to sign up for Part A and B, and a separate 2-month window to enroll in a Part D or Medicare Advantage plan with drug coverage

Answer: No, once your active employer coverage ends, your 8-month Special Enrollment Period starts immediately, and COBRA doesn't extend or pause it. So even if you elect 6 months of COBRA, you still need to enroll in Part A and B within 8 months of your active coverage ending, not 8 months from when COBRA runs out. Waiting until COBRA ends would put you outside the SEP window and risk a late enrollment penalty plus a potential gap in coverage.

Answer: A good rule of thumb is to call your broker in August or September to get an appointment on the calendar before AEP hits. Around that same time, your plan will mail you an Annual Notice of Change, which is the document that tells you exactly what's shifting with your coverage, premiums, and drug formulary for the upcoming year. Read it when it arrives and bring it with you!

Answer: HMO plans require you to stay within their network. If you see a cardiologist outside of that network, you'll most likely be responsible for the entire bill yourself.

HMOs are built around a specific network of doctors and hospitals and you need a referral from your primary care doctor to go see a specialist (like a cardiologist).

Answer: Once you're enrolled in a Medicare Advantage plan, that plan becomes your primary coverage. Original Medicare essentially steps aside. So even though you still have that red, white, and blue card, you can't use it to get covered while you're in a Medicare Advantage plan.

Answer: Prior Authorization isn't going away entirely, but the guardrails around it are getting stronger. Some examples:

CMS has put stricter rules in place requiring Medicare Advantage plans to only deny care that Original Medicare would also deny.

Approval timeframes have tightened. Plans are now required to make prior authorization decisions faster than before, reducing the window where your care is stuck in limbo.

Continuity of care protections exist. If you're in the middle of a course of treatment and your plan changes, there are protections in place to make sure your care isn't interrupted while prior authorization is sorted out.

Answer: Some Medicare Advantage plans actually reward you for taking care of yourself.

Rewards for preventive screenings. Certain plans offer gift cards, flex card credits, or health account dollars when you complete things like your annual wellness visit, mammogram, colonoscopy, or other recommended screenings.

Rewards for annual exams. Getting your yearly checkups (eye exams, dental cleanings, hearing tests) can also trigger rewards on some plans, depending on the carrier.

Healthy activity incentives. Some plans track fitness activity through an app or wearable device and reward you just for hitting step goals or completing workouts consistently.

Answer: Here are 3 ways you can save money on a Medicare Supplement:

1) Work with an independent broker. The exact same plan can vary significantly in price from carrier to carrier. So by comparing across dozens of companies to find you the best rate.

2) Household discounts. Many carriers offer 5 to 12 percent off if another person in your home also has a policy with them

3) Review your plan every year. Carriers raise rates over time, and switching to a different carrier offering the same plan can sometimes save you $50 to $100 or more per month.

Answer: On the surface, Medicare Advantage plans looks like they will save you money. A lot of them come with a $0 monthly premium (some even with a Part B Giveback). Compared to Original Medicare plus a supplement, the upfront cost is much lower. So for someone who's generally healthy and doesn't use a lot of medical services, a Medicare Advantage plan can absolutely save money.

Medicare Advantage plans have copays, deductibles, and out-of-pocket maximums. If you end up needing surgery, a hospital stay, or ongoing treatment for something serious, those costs add up fast. Every plan has an annual out-of-pocket maximum, and in some cases that number can be $7,000, $8,000, or higher.

Answer: Stair lifts are not covered by Medicare. Original Medicare doesn't cover stair lifts because they're classified as a home modification, not durable medical equipment (DME). Even if your doctor recommends one, Medicare Part A and Part B are going to say no.

Medicare Advantage plans typically exclude stair lifts as well. You'd want to check your specific plan's benefits, but don't count on it.

Answer: Medicare isn't simple. There are multiple parts, dozens of plan options, and the wrong choice can cost you thousands of dollars or leave you without access to the doctors you trust. That's where I come in.

Working with an independent Medicare agent like me costs you absolutely nothing. My services are free to you (I'm compensated by the insurance carriers). So you get a knowledgeable guide in your corner without paying a dime extra.

As an independent broker, I'm not locked into one company. I'm contracted with 70+ carriers, which means I can shop the entire market on your behalf and show you options that actually fit your health needs and your budget.